Inflammation and Cancer: What’s the Connection?
While most people diagnosed with breast cancer will be over the age of 50, we’re seeing more women (and those assigned female at birth) receiving a diagnosis of breast cancer in their 40s, 30s, and even 20s. This does not mean that you should panic about breast cancer. What it means is that more than ever it’s important for women to be aware of their own breast health and their personal risk factors to be as proactive as makes sense for them. This is why starting the conversation now is so vital, because understanding what may or may not significantly impact your own personal risk is the first step in deciding what’s right for you.
Understanding inflammation
The connection between inflammation and cancer is complex, and like everything in the body, intertwined with a number of other health issues. The biggest concern when it comes to breast cancer is chronic inflammation.
Inflammation is a normal part of how the body heals and recovers from injury. Ideally once healing has taken place, inflammation drops. In chronic inflammation that same process seems to come on without physical injury and doesn’t clear efficiently, resulting in a persistent change in the body that can start to damage DNA and result in the formation of abnormal cells. This persistent inflammatory state can damage your healthy cells and tissue, as well as weaken your immune system.
Two of the biggest driving factors of inflammation are carrying too much weight on your body and damaging dietary habits (including alcohol).
Inflammation and carrying more weight (most research defines this as a BMI of over 30) go hand-in-hand, as they drive one another and both impact your hormones and breast cancer risk. Carrying too much body fat causes inflammation. This inflammatory reaction then increases the amount of insulin and estrogen in the body, triggering cell division. Additionally, that excess fat will also produce more estrogen. This is why we see a significantly higher risk of breast cancer in overweight women who are on HRT, because this increased weight alone causes an additional 26 cases of breast cancer for every 1000 women (a risk that is more than 6x higher than the risk of breast cancer associated with HRT or the birth control pill).
The risk of breast cancer associated with being overweight also seems to be higher in women after menopause, when their ovaries are no longer producing significant amounts of estrogen. One study found that postmenopausal women who gained weight through / after menopause had a 35% increased risk of breast cancer. In these women, the increased amount of estrogen produced by excess fatty tissue can notably raise estrogen levels. This is especially concerning because the form of estrogen produced is more stimulating and inflammatory than the form of estrogen that was made by your ovaries before menopause.
The other challenge with this is that carrying extra weight increases a woman’s risk of insulin resistance. Studies have found that insulin resistance is associated with a pro-inflammatory state in the body and may even be at the root of treatment failure in women with metastatic breast cancer undergoing chemotherapy.
Identifying inflammation + insulin resistance
Some women are very aware that they have a lot of inflammation in their body because they’re chronically sick (chronic inflammation will suppress the immune system), they have worsening or persistent pain, or their energy is very low despite other potential causes like iron and thyroid being normal. However, for a lot of women chronic inflammation has no signs or symptoms. Similarly, insulin resistance can be hard to identify, as insulin resistance often does not not show up on blood work as high blood sugar levels (but it can be tested for with some basic blood work), and there are a few symptoms that you should pay attention to. Women should be aware that as they enter perimenopause / menopause the risk of insulin resistance rises. For a lot of women this will show up as weight gain without a clear cause, an inability to lose weight, increased cholesterol levels, and even fatty liver. If you want to get more clarity on whether or not these are issues for you, talk to your health care provider about testing inflammatory markers and insulin levels so you can get a clear sense of your own risk.
Reducing inflammation now
The most accessible way you can help reduce inflammation is by becoming more mindful of what you’re eating. For women who really want to get a handle on significant inflammation, following an anti-inflammatory diet until their inflammatory markers come down can be incredibly effective. However, it’s a fairly restrictive and challenging dietary plan to stick to for years, so I always talk to women about changes that can be more sustainable.
Cut out processed foods - this includes soda, fast food, prepared foods, and packaged or instant foods (as well as processed meats). These foods are often lacking in nutrients and much higher in refined flours, refined sugars, and trans / saturated fats. Additionally, they’re often full of artificial ingredients, a combination that can increase CRP levels (one of the inflammatory markers that we can measure on blood work).
Limit red meat to less than 18 oz. per week - this includes pork, beef, lamb, etc. These animal products can increase tumour growth factors (most importantly IGF-1). The concern is that eating these foods too often can not only drive up inflammation but stimulate the growth of cancer cells.
Eat more plant-based meals. This does not mean you have to become vegetarian or vegan. What it means is that 75% of your plate should be vegetables at every meal (including breakfast). These are the only foods that contain phytonutrients, which are highly anti-inflammatory. Additionally, they are also high in antioxidants and fibre which your body uses to help reduce inflammation and clear damaging substances from the body. Research has shown that increasing plant-based foods in the diet can significantly lower CRP.
Focus on eating healthy fats - this includes fish, olive oil, nuts, avocado, flax seeds, and even chia seeds. Dietary fats high in omega-3 fatty acids not only help to reduce inflammation but they actively protect your body from the damage of chronic inflammation. When cooking, always stick with oils that have a high smoke point such as grape seed oil and use olive oil to finish meals or when cooking on very low heat only.
Include moderate intermittent fasting - meaning a 13-14 hour overnight fast. Research has found that intermittent fasting was associated with a 21% reduced risk of dying from breast cancer and with each additional hour of overnight fasting there was an additional 8% decrease in CRP (something to note is that these benefits were not significant when dinner was the lightest meal of the day).
A Final Word
There are so many factors when it comes to the risk of inflammation and breast cancer and the more you understand your own body the more you’ll be able to decide what kind of supportive care and lifestyle changes are most appropriate for you. If you have questions or concerns about your own breast health or breast cancer risk, never hesitate to reach out so you can decide what is right for you and your body!
Ready to make a change?
If you're searching for more guidance and understanding of how you can support your breast health or address breast cancer concerns with naturopathic medicine, you can book a complimentary consult with me here.
Yours in health,
Dr. Hayhlee Clarence, ND
REFERENCES
1. Cao S, et al. Breast Cancer Res Treat. 2019 Feb;173(3):647-655
2. Marinac C. JAMA Oncol. 2016;2(8):1049-55
3. Marinac CR, et al. PLoS One. 2015 Aug 25;10(8):e0136240.